Healthcare Provider Details

I. General information

NPI: 1821059221
Provider Name (Legal Business Name): ELISA SCHERB PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4649 SUNNYSIDE AVE N SUITE 302
SEATTLE WA
98103-6900
US

IV. Provider business mailing address

4649 SUNNYSIDE AVE N SUITE 302
SEATTLE WA
98103-6900
US

V. Phone/Fax

Practice location:
  • Phone: 206-588-0855
  • Fax: 206-588-0397
Mailing address:
  • Phone: 206-588-0855
  • Fax: 206-588-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00010002
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: